Finding alignment with the feds on AI
Investing in artificial intelligence may be a good way to align with the Trump administration while finding ways to streamline an already-lean Medicaid program.
It’s Day 59 of the Trump administration, and the ‘Save Medicaid’ rallies have begun. Legislators from across the country held their day of action on Tuesday in the hopes of pressuring the GOP to not cut Medicaid. We don’t need to tell you how catastrophic cuts would be, especially for enrollees who rely on the program health care benefits including immunizations, dental care, substance use disorder treatment, cancer care and maternal health services. Similarly, federal spending for Medicaid pays for innovation, and the implementation of artificial intelligence could be an interesting area for alignment with the Trump administration
One (Real) Solution To Mitigate Medicaid Fraud and Waste: Artificial Intelligence
A new, primary talking point among Republicans seeking to rationalize proposed deep cuts to federal Medicaid funding is that the nation needs “to address fraud and waste in Medicaid.” We don’t know of a single state Medicaid director who would disagree with that statement. State Medicaid agencies serve dual roles of regulator and payor — chief among those roles is stewardship of federal and state Medicaid funding to ensure that the lion’s share of resources goes to health care coverage and access for Medicaid enrollees. Slashing federal Medicaid funding isn’t a solution to fraud and waste in Medicaid, but AI is.
Three priority areas in which Medicaid programs and the Trump Administration should consider investing in and deploying AI technology include:
Eligibility and enrollment
Program oversight and integrity
Network adequacy and access monitoring
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ICYMI: Cutting Medicaid Could Hurt Millions of Americans Who Need Long-term Care
Long-term care (LTC) services, also referred to as long-term services and supports (LTSS), are a broad range of medical, personal care, rehabilitation or social services a person with physical or cognitive limitations may need. An estimated 70% of Americans will need LTC services in their lifetime.1 For example, a frail, older woman might receive LTC services like: (1) a personal care aide who comes to her home to help her bathe and dress each morning; (2) home modifications to minimize her risk of falling; and (3) transportation to her medical appointments. These services enable her to remain in her home — near family to prevent social isolation — and attain the highest possible quality of life.
LTC and LTSS services can be provided in other settings, such as a nursing home, an assisted living facility or adult day health center. Across the nation, these services are provided not just by paid workers, but also by unpaid family members, friends and neighbors, often because families have no insurance coverage for these services and the cost of paying for them out of pocket is prohibitive.
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80 Million Editor Patti Boozang will discuss potential threats to subsidized health insurance coverage and financing in Massachusetts on a Blue Cross Blue Shield Foundation webinar March 20.
Texas doctors speak about the effect Dobbs has had on medical care.
Manatt announced two new hires to the firm: former CDC Director Dr. Mandy Cohen and Public Health Leader Dr. Vin Gupta.
Tribal health leaders say Medicaid cuts would decimate health programs – KFF Health News
NJ 'will not be able to supplement' federal cuts to Medicaid, Trenton leaders warn – NorthJersey.com
Ramsey County’s Medicaid backlog is so big it is hiring 80 people to tackle it – The Minnesota Star Tribune
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